Self-reported syphilis and gonorrhoea testing among men who have sex with men: national HIV behavioural surveillance system, 2003-5

Tai, Eric; Sanchez, Travis; Lansky, Amy; Mahle, K; Heffelfinger, James D.; Workowski, Kimberly A.

doi:10.1136/sti.2008.030973

Cited by 25 publications

(18 citation statements)

References 19 publications

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“…Compared to our finding of syphilis screening rates of 66.0% to 75.8% and gonorrhea screening rates of 3.0% to 18.3%, a study of self-reported STD testing among HIV-negative MSM during 2003-2005 found lower rates for syphilis (39%) but higher rates for gonorrhea (36%). 22 Several factors can account for our finding of higher screening rates for syphilis than for chlamydia or gonorrhea. Providers were probably aware that untreated syphilis can result in adverse health outcomes, with infection resulting in neurologic or ophthalmic manifestations, and that syphilis infection increases HIV viral load and decreases CD4 cell count in HIV-infected persons, thereby increasing the risk of transmitting HIV.…”

Section: Discussionmentioning

confidence: 89%

STD Screening of HIV-Infected MSM in HIV Clinics

Hoover¹,

Butler²,

Workowski³

et al. 2010

Sexually Transmitted Diseases

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Most asymptomatic HIV-infected MSM were screened for syphilis, indicating good provider adherence to this screening guideline. Low screening rates for gonorrhea and chlamydia, especially at rectal and pharyngeal sites, suggest that substantial barriers exist for complying with these guidelines. The moderate to high prevalence of asymptomatic chlamydial and gonococcal infections underscores the importance of screening. A range of clinical quality improvement interventions are needed to increase screening, including increasing the awareness of nucleic acid amplification tests for nonurethral screening.

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Section: Discussionmentioning

confidence: 89%

STD Screening of HIV-Infected MSM in HIV Clinics

Hoover¹,

Butler²,

Workowski³

et al. 2010

Sexually Transmitted Diseases

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“…Adherence to these screening recommendations is an important strategy for gonorrhea control in sexually active MSM, because asymptomatic infection at pharyngeal and rectal sites is common among this population, and gonococcal transmission is efficient with insertive or receptive rectal intercourse and fellatio [11]. Despite these recommendations, in surveys of sexually active MSM who attend venues frequented by MSM, 36% self-reported being tested for gonorrhea in the past year [13].…”

mentioning

confidence: 98%

Pharyngeal Gonorrhea: An Important Reservoir of Infection?

Weinstock¹,

Workowski²

2009

CLIN INFECT DIS

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“…[13][14][15]42 Studies also suggest that MSM may not screen for HIV and STDs due to perceived low risk for infection and fear of a positive result, as well as concerns over test access, affordability, and confidentiality. 15,19,[43][44][45] Few studies to date, however, have examined HIV and STD testing with exclusively Black MSM samples.…”

mentioning

confidence: 99%

“…Data from the National HIV Behavioral Surveillance System demonstrated that among a venue-based sample of 10,030 MSM, 39% and 36% had been tested for syphilis and gonorrhea in the past year, respectively. 13 Johnson and colleagues 14 found that whereas 81% of MSM has been recently tested for HIV, only 61% had been screened for STDs. Similar results were found in another sample of MSM in Massachusetts.…”

mentioning

confidence: 99%

Health System and Personal Barriers Resulting in Decreased Utilization of HIV and STD Testing Services among At-Risk Black Men Who Have Sex with Men in Massachusetts

Mimiaga

Reisner

Bland

et al. 2009

AIDS Patient Care and STDs

106

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Testing for HIV and other sexually transmitted diseases (STD) remains a cornerstone of public health prevention interventions. This analysis was designed to explore the frequency of testing, as well as health system and personal barriers to testing, among a community-recruited sample of Black men who have sex with men (MSM) at risk for HIV and STDs. Black MSM (n = 197) recruited via modified respondent-driven sampling between January and July 2008 completed an interviewer-administered assessment, with optional voluntary HIV counseling and testing. Logistic regression procedures examined factors associated with not having tested in the 2 years prior to study enrollment for: (1) HIV (among HIV-uninfected participants, n = 145) and (2) STDs (among the entire mixed serostatus sample, n = 197). The odds ratios and their 95% confidence intervals obtained from this analysis were converted to relative risks. (1) HIV: Overall, 33% of HIV-uninfected Black MSM had not been tested for HIV in the 2 years prior to study enrollment. Factors uniquely associated with not having a recent HIV test included: being less educated; engaging in serodiscordant unprotected sex; and never having been HIV tested at a community health clinic, STD clinic, or jail. (2) STDs: Sixty percent had not been tested for STDs in the 2 years prior to study enrollment, and 24% of the sample had never been tested for STDs. Factors uniquely associated with not having a recent STD test included: older age; having had a prior STD; and never having been tested at an emergency department or urgent care clinic. Overlapping factors associated with both not having had a recent HIV or STD test included: substance use during sex; feeling that using a condom during sex is "very difficult"; less frequent contact with other MSM; not visiting a health care provider (HCP) in the past 12 months; having a HCP not recommend HIV or STD testing at their last visit; not having a primary care provider (PCP); current PCP never recommending they get tested for HIV or STDs. In multivariable models adjusting for relevant demographic and behavioral factors, Black MSM who reported that a HCP recommended getting an HIV test (adjusted relative risk [ARR] = 0.26; p = 0.01) or STD test (ARR = 0.11; p = 0.0004) at their last visit in the past 12 months were significantly less likely to have not been tested for HIV or STDs in the past 2 years. Many sexually active Black MSM do not regularly test for HIV or STDs. HCPs play a pivotal role in encouraging testing for Black MSM. Additional provider training is warranted to educate HCPs about the specific health care needs of Black MSM, in order to facilitate access to timely, culturally competent HIV and STD testing and treatment services for this population.

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Self-reported syphilis and gonorrhoea testing among men who have sex with men: national HIV behavioural surveillance system, 2003-5

Abstract: Syphilis and gonorrhoea testing among MSM was low, despite specific testing recommendations in the STD treatment guidelines. To increase STD testing among MSM, healthcare providers should assess the risks of STD for male patients through routine enquiries about sexual activity.

Cited by 25 publications

References 19 publications

STD Screening of HIV-Infected MSM in HIV Clinics

STD Screening of HIV-Infected MSM in HIV Clinics

Pharyngeal Gonorrhea: An Important Reservoir of Infection?

Health System and Personal Barriers Resulting in Decreased Utilization of HIV and STD Testing Services among At-Risk Black Men Who Have Sex with Men in Massachusetts

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